Sugar

Dear Sugar,

You know I love you.  I really do — especially in homemade baked goods, cereal, energy/granola bars, ice cream, and chocolate.

But we have to take a break.

I’m seeing someone else.

Okay, that was a lie.  I’m actually seeing three someone else’s: fat, protein, and vegetables.

And sugar, they are so good to me. They’re better for me than you are.  Our relationship has been fraught with violence and abuse: you make me breakout (which is especially bad given my general hormonal issues), you make me overeat (I thought I could just have a little bit of you and be satisfied, but you’re so demanding — you always say “more, more more”!), and you  make me a little lethargic.

It’s time for a change.  I want more energy.  I want a happier, healthier looking face.  I want to feel like my digestive system is squeaky clean (TMI?).

Moreover, I’m an athlete — I thrive off of running, yoga, strength training, and just generally playing/exploring.  And you slow me down.  I know that all the experts say “carbs before and after a workout”, but I just don’t think that it’s working out for me.  See, that means it’s not you, it’s me.

I hope that we can see each other again some day, but only a little bit at a time.  I want my clear skin back.  I want my marathon energy back.  I want to look forward to eating healthy meals and not dread it.

I hope you are understand.  Feel free to call/text/email me anytime.  I hope we can still be friends!

xoxo, Caronae

And so begins a little experiment: seven days sugar-free. At least, refined-sugar free.  Don’t murder me if I use a dash of maple syrup at some point.  But seriously though, I think something has been bothering my tummy, my body, and my energy levels lately, and I have a suspicion that this white powder (no, not the other white powder) is to blame.

I have been focusing more and more on vegetables, a little fruit, proteins (meat, fish, chicken, yogurt, milk, beans, tofu/soy, eggs, cheese) and fats (EVOO, coconut oil, nut butter, plain nuts, low-fat dairy, whole eggs, cheese, butter, avocados) lately and I love it.  I have lost twelve or so of then nagging pounds I’ve had hanging out since the hospital this summer, and would love to lose about five more to be at my happy weight.  I’m fine with the way I am now, to be honest.  I just want to feel like I can finally get a hold of my weight, for once and for all.

And I think sugar (or at least, excessive sugar), is standing in my way.  I am a woman on a mission.  A very determined woman.  Don’t get in my way. 😉

-A few notes: my goal is NOT complete sugar elimination, jsut serious reduction

Source

-I will probably use a little stevia and maple syrup

-I am going to reevaluate after seven days.

Good night all!

Do you have a healthy relationship with sugar, or are you one of the many people who struggles with it?

The Breast Part

Fair warning: This is a post about my boobs.  If you are a relative or coworker or anyone who doesn’t want to hear me talk about this most wonderful body part, you have been warned.

One of the single biggest influences on my body image, whether positive or negative, is my breasts.

It might sound silly, but it is very, very true.  I don’t know if all women are especially conscious of their breasts, but I always have been.  For the longest time, they were too small (or so I thought).  Granted, I was about 14 years old when I thought this, but still, I was hyper-aware.  It is sort of awkward, conceptually, when you think about it: women have these weird mound-like protrusions from their chest.  Obviously, they serve a very important purpose (i.e., breastfeeding). But for the vast majority of our lives, we aren’t breastfeeding.  During these non-nursing times, breasts become something sort of different: sexual objects.  But I think that a lot of the way we see our breasts isn’t determined by men or sex, but by other women.

When I started high school, I remember thinking that I must be the flattest-chested girl in the entire school.  This wasn’t true at all, but my image of breasts did not fit with how I thought they should be.  This says a lot about how girls are primed, even from a young age — I was thirteen years old.  Over high school, my breasts grew at what was probably a painfully normal rate.  I felt happy with their size when I started college at 17.  I was maybe a small C cup at that point.  Since then, they’ve grown about two more sizes.  This is not what I wanted to happen, at all.  I feel like women are constantly made to understand that their bodies can be perfectly controlled, in terms of size and shape.  Breasts are a perfect example of why this is not true.

In the last four years, I have been on and off various hormones.  About two years ago, I finally settled on a birth control pill that worked well (I was only using it to control my period, headaches, acne, etc.).  After having pulmonary emboli, however, hormones are out of my life permanently.  At first I thought this would be nice and cleansing; more authentic to how my body should be.  But after a solid six months hormone-free, I have to say that I am hating it.  I have terrible acne for half the month, awful cramps and headaches, and my moods are not only terrible but unpredictable.  I cannot believe that women lived like this for thousands of years before the invention of the pill.

Whatever.  My point is that the lack of birth control hormones in my system has had another unpleasant side effect: my boobs have been growing like rabid animals.  Ugh.

It’s frustrating to feel like I reached a point where I was satisfied with my breast size and now they’re growing beyond my control.  I despise not being in control.  But that’s just the thing: I have been made to believe, all my life, that my body can be shaped and contorted and dominated like a bonsai tree. This is not the case, and it never will be; there are a million factors that play a role in determining the size and shape of all our various body parts.

So why do I let my boobs affect my self-esteem so much?  I’m constantly aware of their size; I feel like they’re awkward and too big all the time.  My younger high school self thought they were too small, making me somehow un-womanly.   There are, of course, some practical reasons for my current self-consciousness about them: plain and simple, they get in the way.  It would be so much easier to run with smaller boobs.  There are certain yoga poses where I feel like I’m being strangled by a small human sitting on my chest, until I realize that it’s really just my own breasts.

Other times, I feel like I’m being stared at by men.  I don’t think I’m imagining it.  It doesn’t matter where I am or what I’m doing; men ogle.  And I am so tired of it.  I am much more than whatever sexuality my breasts represent.  I think I have a nice face, too.  Is it somehow less important?

It’s a funny conundrum: my breasts are sometimes wonderful, sexual objects and are other times obnoxious, uncomfortable objects.  Depending on which side of this equation they fall on on any given day, my self-esteem is either high or low.  By no means are breasts the only determinant of my (or any other woman’s) self-esteem.  But they are a pretty big factor.  Sometimes I wish they would just go away entirely.

I am going to try to be nicer to my breasts.  After all, they do have an important purpose.  Many women would probably be thrilled to have my boobs.  I guess we want what we can’t have.  And short of a breast reduction, which I don’t think I would really want anyway, my boobs are not going to be changing much.  L (my therapist) is always trying to get me to accept things the way they are, at least in moments like this.  I think that my self-consciousness about my breasts is a moment where I need to just accept myself: that means accepting the good and the bad.  Sometimes it’s nice to get a little attention.  Other times it’s downright obnoxious.  Sometimes they make me feel very womanly.  Other times they feel big and horrible.  Overall, they are a wonderful, albeit confusing, body part over which I don’t really have control.

So be it.

Your feelings on your boobs?  How do they affect your self-esteem?

It’s All Mental (And Physical!)

Today’s Happy Note: Sunbutter.  I know that sunflower seed butter is made from a kind of a modified sunflower seed and has some added sugar and oils.  But I. Don’t. Care.  It is my new favorite nut butter and I am in love.  Nut butter heaven.  If that is a real place, I am so going there.

Marathon Training: Yesterday was a day off running.  I did about 15 minutes of yoga then lifted my beloved weights for 45 minutes. I really do love weight-lifting.  It’s oddly relaxing.  Anyone with me on this?

Today was a speed workout day.  It may officially have been the longest speed workout of my life:

2 mile warm-up

4 x (2 mile @ Tempo pace, 1/2 mile easy)

2 mile cool-down

It ended up being a whopping 14 miles! That’s longer than my long run on Sunday.  It was a really good workout — I felt strong and fast, but not too fast; I think I paced myself pretty well.  I definitely needed a succesful workout, mentally.  I was super anxious to get started and have been feeling a bit down about running lately.  This brought my spirits back up! I estimated the distance for the fast portions using the street numberings on lamp posts in CP (a well-kept but amazing secret — the first two numbers on any lamp post correspond to the street cumber you are at, and there are 20 blocks to a mile).

An awesome mid-week workout, although 14 miles is kind of a time-suck.

All-Around Health

I want to talk a little bit about the intersections between mental and physical health today.  I think that it’s easy to become too focused on the physical aspect of health: mainstream media frequently portrays a narrow, singular conception of health which is framed largely around the exclusion of non-physical elements.  For example, you see advertisements at drug stores with people working out at a gym and eating salads and taking supplements.  Or there are segments on news shows telling us “how to get healthy” by doing this new exercise or eating this new superfood. One of the reasons I think that Caitlin’s book, Operation Beautiful, is wonderful (and has been so successful) is because it addresses a legitimate need for emotional health information and empowerment, both amongst individuals who already consider themselves to be relatively healthy(e.g., bloggers) and amongst those who don’t know where to start, physically or emotionally. I try to deal with things holistically, although I am not always successful.  But the fun part is the journey, not perfection.

In the last two years, I have had a physical health crisis and a mental health crisis.  My experiences with each were very different, but both were powerfully formative for my conception of myself — I learned so much about my unique strengths and talents from each.  I began to understand my way of seeing the world; where I fit into things.  I think these crises helped me to figure out love — how to love myself and others.  I am not saying that you need to have a crisis in order to take care of yourself though!  There are simple things that we can all do, everyday, to make our lives the best they can be.  After all, I think that’s what health is about: living our happiest, most vibrant lives.

If my years in college have taught me anything, thus far, it is that I need to take the time to be healthy.  Taking time for myself has saved my life.

Before talking about the spaces between emotional and bodily health, I want to share some research/articles on the matter.  Some of these are more scientific than others, but I think that they all involve a good overview on the relationship or specific facets of the relationship.

How Does Exercise Improve Mental Health?

Psychoendoneuroimmunology — relationship between stress and mental coping skills and somatic illness

Meditation Can Boost The Immune System

Exercise As an Antidepressant

Finding Thinner Peace II — eating right for our mind and body

Exercise, Mental Health, and Mental Ability

The Connection Between Mental and Physical Health — great roundup of articles

Improving Emotional Health — a more general but still useful overview of emotional wellbeing and its intersections with physical indicators

Surgeon General’s Report on Mental Health — this has almost nothing to do with bodily health, but is a comprehensive overview of mental health (including disorders)

Most of these articles focus on the relationship between mental health and exercise.  I think this is certainly important, but it would be shallow to consider it the only significant aspect of the way our emotional and bodily health intersect.

For me, physical health means a constellation of things: regular exercise/movement (running, yoga, and weights), a good diet full of lots of plants, protein, and healthy fats, regular communication with my doctors, management of my clotting problem and my hormonal/endocrine disorders, and generally taking care of my body — proper rest, attention to appearance, stretching, etc.

Mental health also means a variety of things, for me: managing my depression/anxiety/mood, actively seeking happiness and contentment, healthy social relationships and connections, a sense of calm/inner peace/spirituality, and a general awareness of my place in the world.

By no means do I think that people conceive of physical and mental health in the same ways.  Even a more generic inquiry into “health” would yield vastly different responses from similar individuals.  My point here is to notice and acknowledge what being physically and emotionally healthy means, for me, and to think about how these definitions relate and overlap and inform one another.

There is a certain calmness that washes over me on occasion.  It happens when I feel best about my body and content with my life.  It represents my ultimate healthy state. In it I feel alert, safe, and well.  I notice what my body is thinking and wanting and what my mind is thinking and wanting.  Sometimes these things are different, and that’s okay.  I accept myself for where I am at in that moment.  I am exquisitely attentive yet also tuned out from the rest of the world.  My body has moved sufficiently and been well-fed, and my intellect has been active and my emotions have been even-keeled.  This is, I suppose, my ideal intersection point.

Of course, this is not my everyday reality.  No one who knows me well would ever think to describe me as a calm or collected person.  I can be hysterical or just plain crazy.  On a regular basis.

My thought patterns have a huge effect on how I feel, physically.  When I notice that I am harshly judging myself and hating my body, I tense up — I can feel the pit of my stomach clenching and my shoulders hovering up by my ears.  Or, for another example, when I hear from my doctor that my INR is too low (for the third time in two weeks, as was the case today), I start panicking.  My thoughts race, I can’t do school work, I am suddenly unhappy.

I wish I had a graph or something scientific whereby I could chart the precise overlap of my mental and physical health over a given period of time.  For now, vague descriptions like this will have to do.  All I know, in conclusion, is that there is a connection between my body and mind beyond my spinal cord: yes, my spine runs into my brain stem which opens up into the cerebrum.  But something more is happening here.  I have a sudden change in mood after a quick, sweaty run.  I feel different sensations in my chest and lungs and stomach when I have more fulfilling interactions with those around me.

I think the conclusion is that I don’t know precisely what is going on.  Rather, I am attuned to the patterns and the existence of the connection.  And I think that the details of this connection are probably different for different people.

And that’s okay.

How do mental and physical health intersect for you?  Or you more appreciative of one over the other?  How do you balance the varied roles that they play in your life?  What would you change, if you could?

The Monster Post That Almost Wasn’t

Today’s Happy Note: USB. Makes me oh so very happy.  It stuns me every day.  This morning, he was getting into a cab to go to the airport and I walked the other way, towards the train station.  As the cab pulled away, he called me and said “you have a beautiful smile; you were beautiful walking away.”

Um, is he purposely trying to make me melt???

Okay, so this is going to be a monster post!  Lots of running and workouts and meals and snacks and thoughts!

First, where have I been?  I know that you all probably don’t care about the mundane details of my life, but I like to make lists.  So I am making this list.  Of the ten billion things going on in my life right now. It clears my head (FYI: these are not necessarily in order of importance):

1. School. School school school.  I have six classes (okay, so one is yoga) and I’m a history major.  Which means I spend my evenings reading hundreds and hundreds of pages about early Sumerian writing systems and the intricacies of Iran’s 19th Century civil service system.  I have to keep everything on track and get a lot of forms and such in so that I can graduate on time this May (wow, I can’t believe that it’s only eight months away).

2. LSAT/Law School Applications. Quite frankly, I have been neglecting my LSAT studies.  Hello more logic games and less fun.  I think that part of the problem here is the anxiety surrounding my future.  I am quite confident that the LSAT/law school application thing is the right thing for me to do at this moment in my life, though.  And the anxiety dissipates more and more as I become surer and surer that this is what I want to do.  And if I don’t get in, so be it.  The world will not end.

3. Health. I had. A. Pulmonary. Embolism. Two. Months. Ago. My Warfarin management is going decently, but my INR levels have been inconsistent, at best.  I have, currently, seven doctors, you read that right, seven, plus doctor mom and doctor dad.  A PCP, a warfarin-management doctor, a gynecologist, an endocrinologist, a pulmonologist, a hematologist, and, the most important, a psychologist (L).  I will most likely have to undergo some genetic testing soon to see what caused my emboli and if I have a serious long-term clotting disorder.  I also have to sort out my endocrine/hormonal problems.   So there is quite a lot going on here.  Not to mention taking care of my depression and anxiety, which is muy importante right now.

4. Marathon Training. Need I say more?  Last week I hit 45 miles, next week and the weeks after I will be at 50-55.  Not to mention the amount of non-running time I spend stretching, eating, sleeping, thinking about running, eating, more eating.  Lots of mental and physical energy is expended here.

5. Social Life. My friends are super important to my sanity.  I love them.  They love me.  They keep me happy and healthy and glowing in a way that no amount of exercise ever will.  Spending time with them, whether it’s studying or eating cupcakes together, is something I have learned cannot be sacrificed.  Not to mention USB.  And love.  And sharing things.  And understanding another person like that.

6. Blog/Writing. Not to much to say here besides that these things are super important to me and I won’t be giving them up entirely either. I need them.

7. Family. Duh.  Most important people in the world.

8. Work. I love my job and wish I could work a bit more, but I’m having to squeeze in 8-10 hours in a week where I can. No working=no money, therefore it is absolutely necessary.

Reading this back over, I feel like I am sounding a bit wimpy.  I should be able to handle this.  I can handle this.  Time management.  And self-love.  those are the crucial things right now.

I can make it through these next few months, I know I can.

I have changed my mind about the direction of this post.  Don’t really want to talk about running at all.  I took an extra day off this week (today) which I am feeling guilty about.  But I know I needed it.  I ran this week.  Lifted weights and did some yoga.  The end.

Mostly, I just want to stop talking and show you pictures of yummy things:

Annnnnnnnnd my pictures aren’t uploading.  I think that signals the end of this post.

Goodnight my friends!

Thank you for always being there; I truly feel so supported by you guys!

Adventure Saturday: Ocean, Body Image/Weight Concerns

Today’s Happy Note: Vitamin D overload.  Sunshine! 🙂

I ended up walking 5 or so miles yesterday; I also did a 20 minute yoga core download.  Today I did 3-4 miles walking, 2 miles running (on the beach!!!) and lots of playing in the water.

I had an awesome beach trip.  I always forget that Manhattan is so close to the ocean.  Twas lovely!

Confession: I felt so unbelievably, ridiculously fat in my swimsuit.  I wanted to hide in the changing rooms and cry.  I told my dad that I should not be allowed on the beach without a sign that said “whale.”

And then I hate myself for hating myself so much.  Oh, the irony.

The reality is that, between the GI illness and the hospitalization, I have gained about ten pounds.  I am not someone who could afford to gain ten pounds.  I’m pretty sure this makes me borderline overweight.   I don’t care so much about that label as feeling good and feeling confident.  I don’t feel either right now.  I feel enormous.

I am not necessarily mad at myself: I have hardly been able to workout in the last month, and I have been quite stressed.   I respond to stress by eating emotionally and gaining weight easily.  Seriously, I probably even gained weight when I had my GI thing and all I could eat for three or four days was the occasional piece of toast.

I played on the beach today for hours and ended up having a lot of fun; I dug my toes into the sand, ran up and down, jumped over the waves, swam through the waves, and bothered my sister (endlessly entertaining).  So I am not entirely focused on my body, but it is still there.  It’s this painful, nagging thing in the background.  It’s like something isn’t quite right, and my body knows this, physically and mentally.

The thing that works best for me is not obsessing, but not being lax either.  Counting calories, tracking meals, only “allowing” certain food: none of this works for me. This all creates more tension and anxiety and makes me more sad and I feel worse about my body and I end up eating more.  Funny how that cycle works.  But at least I can recognize it.  In fact, I think I do know what works: eating three wholesome meals a day (plus an afternoon snack and a small dessert), with lots of healthy fats, protein, and veggies, and not snacking in the evening.  It’s as simple as that.

Pretty straightforward.  That’s my plan.  I do intend to use the blog to keep myself accountable. Accountability is where I have failed in the past.  So I intend to do a tiny little check-in with myself when I post, mostly to note whether or not I have been mindlessly eating in the evenings.

Once in a while, I might share a full day of eats.  Like today, since I figured it would be a good idea to have a baseline image of how much I need in a day on an active day where I don’t overeat.

I am sorry if this upsets anyone: if you feel like this would not be a good idea for you to read about, PLEASE skip over it.  I would not want to hurt anyone, especially if you have a history of ED/disordered eating.

Breakfast was flax oatmeal (TJ’s brand) with part of a peach (would have used it all but parts were squishy and I hate that) and a giant scoop of AB.  One of my favorite breakfasts!

Lunch=giant salad with cucumbers, zuchinni, carrots, microwaved eggs, and avocado.

Afternoon snack — it was super melty since it had been at the beach with me all day and it was a hundred degrees!

A few bites of coleslaw and a giant Asian chicken salad for dinner (the size of my head).  You can’t see the chicken and other toppings, but I promise they’re there!

On the left is a peanut butter cup shake I had before going to a play with my dad and sister.  Right was my before blogging/bed snack of a small Godiva truffle.  I REFUSE to go without dessert.  Ever. Regardless of my weight.  I’m sure this is some kind of dieting sin.  But I don’t care.

So there you have it.  I do want to lost a bit of weight.  It’s very hard for me to find a balance between vigilance and obsession; I am aiming to use the blog to help me find a balance over the next few months (that won’t be the only thing on the blog though, don’t worry!).   Due to my body’s natural  (and rather unfortunate) chemistry/metabolism, I do need to have a certain vigilance.  It sounds bizarre, but if I am not careful and I gain weight now, I could screw over my fertility in the future.  Very random, I know.  But I want to be a mother more than anything in the world and so I am not going to take any chances with this.

Any thoughts?

Hospital, Part II

Today’s Happy Note: Getting a pedicure.  Never had one before.  It was wonderful.  Now my feet are clean and shiny and soft!

Thank you all for your support yesterday, and as I continue to tackle this illness.  It won’t be easy but I know I’ll come out alive, hopefully having learned some lessons and had some nice moments along the way!  Yesterday you all solidified my belief in human compassion.  It binds us and nurtures us like nothing else.

I have been having a fun, relaxing few days with my mama.  I get tired pretty easily and really winded walking fast or up a hill or stairs.  Still, we have walked a lot.  I think it’s been good to get my legs moving a bit and some fresh air (if you can call NYC air “fresh”) into my lungs.  Still no coughing or chest pain or tightness in my legs (which could signify new clots).

One of the funny things about this health scare was that it made me realize how healthy I already am.  In fact, because my heart and lungs were (and are) so strong, the doctors almost missed it.  When I was actually in the hospital, I was the only patient on my floor who seemed to be actively moving and thinking and writing and feeling.  At first I thought the nurses were annoyed by my constant activity (if I wasn’t cleaning my room and folding the blankets, I was walking around the floor, or doing a sudoku puzzle, or asking the doctors about my test results), but then I realized that it really just wasn’t something they were used to.   All the other patients just sort of laid in their beds staring at the TV or sleeping.  I am not judging them — they might have been sicker or older or just plain old tired — but it made me grateful for the health that I do have.  I may not have the perfect body and sometimes I eat too much sugar.  But I do a damn decent job.

Hospital pictures:

I am taking the next few days to relax some more.  I will have to do some work from home.  But I also plan on reading, writing, baking, napping, seeing movies/concerts, drawing, snuggling, and just generally taking a break.  Any other suggestions? I can leave the house but get tired easily, so I try not to be out and about all day.  I might do an easy yoga class tomorrow, because I’m getting stiff and bored of not moving.  I think it would be a nice, calming stretch.

There are also plenty more issues related to the Pulmonary Emboli that I have to follow up on.  I have an appointment to see a blood clot specialist and a endocrinologist-gynecologist.  I also am having twice weekly blood tests, doctors appointments, and another heart Echo in a few weeks.  Unfortunately, my INR has not gotten up high enough yet.  It was only 1.2 today so I need to take more Coumadin and continue the Lovenox for a while (I learned how to inject myself this morning!).  My dad and sister are coming this Thursday or Friday for a few days.

Posting might be back to normal soon.  It all depends on how my health is; if I am still having issues with the clots or the medication or my INR, then I’m going to talk about that.  I will, of course, try to include other, more fun health-related things.

Tomorrow I have to tell you about two fun restaurants I have gone to since getting out of the hospital!

Have you ever been hospitalized?

What’s the most compassionate thing someone has ever done for you?

Scariest Moments of my Life

Hello beautiful friends!  I have missed you all so much during my absence.  But I do have a good (albeit scary) story to tell you!  I want to preface this by saying that I am so grateful for all the love and support everyone has given me during the last few days; without my family and friends this would have been very difficult to get through.  Our human connections lend a lot of grace and beauty to the smallest moments; illustrative examples to follow.  If ever I had forgotten how much people love me and treasure me and care for me, well, now I know just how much they do.  I feel like I’m looking at love from a slightly different angle now.  I think I am beginning to understand how compassion alights through us.

This past week was really hot and humid.  Like, painfully hot, and as you all know, I sort of wilt in the heat.  By Wednesday, I wasn’t really feeling myself.  I kept getting out of breath on my walk to work.  I attributed it to the weather and the droll, tired pattern of mid-summer days.  In the evening, I went for a run.  I had to stop every half a mile or so and ended up only running three and walking two.  I threw in some yoga and abs in the middle and felt decent, but thought that I might be having some asthma.  I called my dad and he suggested I should make an appointment with my doctor for the next day; I might need an inhaler.

In the morning, while I walked to work, I called the doctor (which is conveniently right next to my office) and made an appointment for 2:00.  I still felt tired/short of breath and my chest hurt a little bit around my sternum, but again, I wrote it off as asthma.  At work, I pretty much sat at my desk typing away for five hours.  The office is air-conditioned and calm.  I felt fine, but avoided any excessive trips up and down the stairs.  I left my work spread out on my desk and my lunch in the fridge when I headed to the doctor, thinking I would be back in thirty or forty minutes.

I finally got into the room with Sam, the nurse practitioner, about a half hour behind schedule.  I was a wee bit cranky because I wanted to get back to work and finish what I had been doing.  I told him I was there to follow up on my GI infection of two weeks ago (I was almost back to normal) and to tell him that I was a little bit out of breath, probably because of the heat/humidity/air quality.  He took my pulse, blood pressure, and blood oxygen levels; all normal.  I told him that it was much worse when I moved around.  So he did something that probably saved my life: he took my blood oxygen levels while I walked up and down the stairs.  The level dropped pretty rapidly to 89, which is not considered near normal range, especially for a runner.  He saw how out of breath I was and seemed concerned.  We went back to the office and talked for a few minutes.  Then he walked me over to the urgent care, which is just in the next office over, where he talked to other doctors.  At this point, I was really scared: I sat in a room with the door wide open while a cluster of doctors and nurses talked literally five feet outside the door.  I could hear everything they were saying: basically, there was a lot of “this is not normal” and “this is dangerous.”  They started saying that I was going to have to go to the hospital, which made me nervous, but I also felt skeptical.  I really thought I was perfectly fine.  I called my mom and started crying and told her they wanted me to go to the ER.  She said it was okay and probably not serious.

The NP (Sam) got a nurse who got a wheelchair to take me to the ER – the hospital is across the street.  I refused to get in the wheelchair and told them that was a ridiculous idea.  We walked over instead.  She helped me sign in.  Because I was having chest pain (albeit mild), I got moved to the front of the queue.  I talked to the triage nurse who sent me back to see the pediatric ER nurses (like last time; I’m not yet 21).  I told the nurse my symptoms and explained that I didn’t really know why I was there because it wasn’t that serious.  I waited around for an hour or so then saw a doctor who was clearly a resident (a very very hot resident; like hotter than TV doctors hot).  He was concerned that I could have a blood clot (um, what?), although my blood oxygen levels were back to normal.  He ordered some blood tests; mainly, a test called D-Dimer, which measures the concentration of a protein that forms in the blood if you have a clot.  The test, however, does not mean that you necessarily have a clot, it just indicates a problem.  I waited around some more for them to draw blood.  Then I waited another hour for the test results.  It came back positive (triple the normal level).  That meant that the (hot) doctor had to order a CAT (CT) Scan which would actually use a dye to look inside my lungs.  I waited for a while to go up to the scanning room; they made me go in a wheelchair which greatly annoyed me.  A technician injected dye into my IV catheter (which nurses had put in when I first got there) and took a bunch of pictures.  I went back downstairs.   Meanwhile, doctors looked at very thin cross sections of my torso (from my collarbone down to my liver) taken in the CT pictures.

I waited around another half hour or so (I arrived at 3:15; it was probably about 6:30 or 7:00 by now).  I was sitting in my little “cubicle” in the ER, listening to a plethora of loud, hurting children (NOT something you want to hear for six hours).  After a while, the doctor came up to me, accompanied by the attending physician.  They had sort of grim looks on their faces and the first thing he said was “I have bad news for you.”  He spent the next five or so minutes explaining to me what that bad news was; I was crying and shaking because I was just so anxious.  He kind of forgot to mention that I would be okay until after he explained the problem.  So at this point I basically thought I was going to die.

He told me that I had two large pulmonary embolisms, one in the main artery running through each lung.  This is a very dangerous condition.  If I had not come to the hospital, I could have died!  A pulmonary embolism (PE) is the same thing as a gigantic blood clot.  When you have big clots hanging out in your lungs, you can stop breathing.  I cannot describe how I felt at this moment with any word other than “terror.”  I was by myself and did not understand what was happening to me.  All I can say is that human kindness carried me through.  The hot doctor was super nice to me and explained everything very carefully.  He talked to my mom on the phone.  The nurses patted me on the shoulder when they drew blood or gave me injections.  The woman whose daughter was across the hall with a knee injury came over and hugged me.  My aunt called her cousin (my second cousin) who eventually was able to come by.  I can’t thank all these people enough.  You don’t really understand what compassion means until a stranger is holding your hand in an ER, telling you that you will be okay.

The doctor told me that I would have to be admitted and stay in the hospital for several days.  I had only been to the ER for the first time two weeks before.  So now, within a single month, not only did I have my second ER visit, but I was actually being admitted!  Terror no longer accurately describes the feeling that was spreading from my stomach out into my limbs.  The doctor ordered a shot of a drug called Lovenox.  This is an IV or injected drug that prevents any new clots from forming.  I had to wait two hours to get the shot, which was apparently dangerously long.  I talked to both of my parents a lot more during this time.  They were pretty freaked out.  In fact, everyone around me was pretty freaked out: here was this healthy, young woman presenting with a deadly disease, with virtually no explanation.  As each test result came back positive, I could read the confusion on the doctors’ faces.  There are several risk factors for PE: smoking, immobility or serious inactivity, surgery, cancer, leg fractures, family history, and taking birth control.  I do take birth control for my PCOS.  As was later discovered, I also have a family history, but we didn’t really realize this at the time.

A nurse finally came around to give me the Lovenox.  She told me it would go into my stomach, into subcutaneous tissue.  This was too much.  I burst into tears and yelled at her and told her I did not want the injection.  She calmed me down within a few minutes and gave me the injection.  It kind of hurts – not when the needle goes in – but when the drug is actually pushed into the stomach fat.  After this, I had to wait for patient transport who would take me to a different building where my room would be.  The transport finally came and they put me into a bed.  I got wheeled to the Sixth Floor West wing, where I would be for the next three days.

I got up to the floor and went into my room.  It was what a hospital room seemed like it would be; two patients to a room, a small box of toiletries, a curtain, a giant bed that I could make go up and down (very entertaining!), thin blankets, an icky inpatient gown, oxygen machines.  I was in room 20A, right outside the nurses’ station.  I met the attending physician for the evening, who really just reiterated to me my condition and the seriousness of it.  He gave me oxygen via a plastic tube thingy going into my nose.  He talked about the medications I would be on for the next few days.  In addition to the injected Lovenox, I would have to take a pill called Coumadin.  I had my blood drawn some more and took more pills.  I was extremely tired but so hugely anxious that I couldn’t sleep at all.  I slept for maybe five hours that night.  My second cousin (and another second cousin who came later) stayed until 11:00 or so with me.  They brought me a sandwich and a pastry because I had missed dinner.  I was hangry by this point.

I was awoken at six the next morning by my first nurse, Joan (I had three other nurses: Remy, Adrian, and John).  She did my blood pressure, blood oxygen, and drew blood.  My iron and a few other things were a bit low, but the most important test done was for my INR.  INR stands for International Normalized Ratio.  It measures the ability of the blood to coagulate.  It is supposed to be a little less than one in healthy people, however, my blood needed to be thinned out quickly, so we had to get it up to between two and three.  It was only 1.2 the first morning.  After that, I was taken to have an echocardiogram taken of my heart.

That took a while (you have to keep waiting for “patient transport”, and they are slooooooow).  I didn’t get back to my room until almost ten.  I asked when I could have breakfast and they were like “you missed breakfast.”  I almost cried.  I told them that they needed to go find someone who could bring me something, and finally they did.  I saw the breakfast choices; basically cereal, whole milk, banana, tea, bread, hard boiled eggs.  Not terrible but not great.  I was really craving some peanut butter!  I then looked over the menu that they gave me for the rest of the day and told them that it was not going to work.  They sent a nutritionist up and I wrote the department a letter explaining why they needed more produce, decent protein, whole grains, and healthy fats on their menus.  Hey, it gave me something to do!  The food didn’t get much better so I didn’t eat a lot.

In addition to the Lovenox, I had to start taking a drug called Coumadin (the brand name for Warfarin).  The clots were still big and my heart was dilated because of the pressure from my lungs.  Scary.  The rest of that day (Friday) was really boring.  Lots of random tests and meetings with doctors; I met the attending for the floor, a physician’s assistant, and a pulmonologist. More pills.  More blood draws, more tests, more doctors, more nurses.  I had visitors though!  I had friends, people from work, relatives.  By Friday night, my mom had arrived.  People brought me cards, chocolate, magazines, flowers.  I read lots of books and walked up and down the hallway ten billion times.  I chatted with the nurses.  Everyone was surprised because I had basically no symptoms outside of a mild shortness of breath.  There was no chest pain, no coughing, and no low blood oxygen levels. Because of all of this, they said that I would be able to go home the next day (Saturday)!  I was a little nervous because I wasn’t sure what the situation with the clots was.  But my doctors explained it: the clots (PEs) are still in my lungs, but, while the drugs are thinning out my blood, the clots are moving to the periphery of my lungs and slowly beginning to dissolve.  They will dissolve (and hopefully never come back!) within two weeks, in theory.  I can rest at home while they dissolve.

This still seems so much to take in.  I am reeling, anxious, not sleeping at night.  My mom injects me with the Lovenox every morning and I take the Coumadin at night.  I have to have blood tests drawn tomorrow morning and every few weeks thereafter for at least six months.  I will be on the Coumadin for at least that long.  If I have a certain genetic abnormality or I ever develop more emboli, I will be on blood thinners the rest of my life.  I will not be able to drink alcohol, take ibuprofen, or take long flights without being extremely careful.  I will have to have the level of Coumadin in my blood measured constantly to make sure that the INR is between two and three.  I will meet with gynecologists, reproductive endocrinologists, pulmonologists, clot specialists, internists, and nurses.  We will need to figure out why a healthy, young person developed massive pulmonary embolisms.  Usually, this is a condition associated with older or less healthy individuals.  I will never again be able to take birth control, which could cause a clot again.  I will have to find alternative medications to manage my PCOS or else I could quickly become infertile.

But.  At this point I’m alive.  And that is all I can ask for.  So many other things seem trivial right now.  I have walked around with my mom a bit today.  Gone to museums, eaten whatever I wanted.  If I walk too much I have trouble breathing and have to sit down.  Stairs and hills are especially hard.  I have lots of pretty flowers in my apartment to look at and chocolate to eat.

I might go back to work Wednesday.  We shall see.  I have a lot to do for my non-profit job so I’m a little lost on that.  But I know things can and will get back to normal.  My life will always be different because of this; I will have to exercise extraordinary caution in doing everyday things and in more serious things, like pregnancy, or surgeries.  This is something that, unfortunately, can never be removed from my medical history.  I am so thrilled to be alive right now: thrilled to touch my mama’s shoulder and hear her breathing.  Thrilled to be able to pick up pears and avocadoes at the grocery store.  It’s hard to describe.  Coming back from that sort of panic and terror and near-death experience, I am most definitely different.  Stronger.  I am not sure how, but I am sure that things will begin to unfold before me as I move forward.  And I will move forward.

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